Method and apparatus for discontinuous dermabrasion

ABSTRACT

Exemplary embodiments of method and apparatus are provided for resurfacing of skin that includes formation of a plurality of small holes, e.g., having widths less than about 1 mm or 0.5 mm. For example, such small holes can be produced using a mechanical apparatus that includes one or more abrading elements provided at the end of one or more rotating shafts, thus avoiding generation of thermal damage as occurs with conventional laser resurfacing procedures and devices. The holes thus formed can be well-tolerated by the skin, and may exhibit shorter healing times and less swelling than conventional resurfacing procedures. The fractional surface coverage of the holes can be between about 0.1 and 0.7, or between about 0.2 and 0.5. The method and apparatus can produce cosmetic improvements in the skin appearance by eliciting a healing response.

CROSS REFERENCE TO RELATED APPLICATION

The present application claims priority from U.S. Provisional PatentApplication Ser. No. 61/437,500 filed Jan. 28, 2011, the disclosure ofwhich is incorporated herein by reference in its entirety.

FIELD OF THE INVENTION

The present invention relates to exemplary embodiments of methods andapparatus for generating a plurality of small damaged regions inbiological tissue, e.g., in skin or the like.

BACKGROUND INFORMATION

Conventional dermabrasion devices and techniques generally involveremoval of an entire surface layer of skin tissue using mechanical means(for example, a rotating diamond head). Such techniques can produce arejuvenating effect on the skin, but they generally require an extendedhealing time (during which the skin appears red and irritated) and maybe very painful.

Procedures and devices for generating fractional damage in tissue aregaining increased attention and usage. Fractional damage includesforming small regions of damage in tissue (e.g., ablation or thermaldamage) that are surrounded by healthy tissue. The small size of thedamaged regions and proximity of healthy tissue can facilitate rapidhealing of the damaged regions, as well as other desirable effects suchas tissue shrinkage. Present approaches for generating fractional damagetypically involve the use of expensive and potentially dangerous lasersor other sources of intense optical energy to damaged tissue, and canalso generate associated thermal damage in the tissue which may beundesirable.

Accordingly, there is a need for a relatively simple, inexpensive, andsafe dermabrasion method and apparatus that can reduce or eliminate someof the undesirable side effects of conventional dermabrasion procedures.

SUMMARY OF EXEMPLARY EMBODIMENTS

The herein described exemplary embodiments pertain to cosmetic methodand apparatus. Synergetic effects can arise from different combinationsof the features and embodiments described herein, although all suchcombinations might not be described in detail. Further, all exemplaryembodiments of the present invention concerning a method can be carriedout with the order of the steps and/or procedures as described;nevertheless this has not to be the only and essential order of thesteps and/or procedures of the exemplary method. All different ordersand combinations of the method steps and/or procedures are herewithdescribed.

The exemplary embodiments of the present invention describe simple,inexpensive, and safe methods and devices for a mechanical generation ofa plurality of small regions of damage in biological tissue by abradingsmall discrete regions of the tissue. Such damaged regions can have asize that is, e.g., about 1 mm or less as measured in at least onedirection along the tissue surface.

An exemplary apparatus can be provided that includes one or more shaftsthat are freely rotatable. For example, the shafts can be configured topass through a substrate or housing, or otherwise rotatably coupledthereto. The shafts can further be translatable along the longitudinalaxis of the shafts relative to the substrate or housing. The shafts canfurther be provided with an abrading element at the distal end thereof.The abrading elements can be configured to contact the tissue surface toabrade a plurality of small, discrete regions of tissue when the shaftsare rotated and/or impacted against the surface of the tissue. A widthor diameter of the abrading elements can be small, e.g., about 1 mm orless, for example, less than about 0.8 mm, or less than about 0.5 mm,e.g., between about 0.3 mm and about 0.5 mm. Such small sizes of theabrading elements can facilitate removal of small portions of tissue andgeneration of small regions of abraded damage, e.g., holes, in thetissue. The substrate and shafts can be arranged to control and/or limitthe depth of penetration or contact of the abrading elements into thetissue when the substrate is placed on or proximal to the tissuesurface.

The damaged regions can be holes or disrupted tissue that result frommechanically abrading portions of tissue, e.g., by contacting therotating abrading elements with the tissue surface. Such damaged regionscan be generated in regular patterns or arrays, in one or more rows, inrandom spatial distributions, or in other patterns. The fraction oftissue surface area covered by the damaged regions can be between about0.1 and 0.7, or between about 0.2 and about 0.5. Larger or smaller arealcoverages can be generated in further embodiments.

In a further exemplary embodiment, the exemplary apparatus can furtherinclude a vacuum conduit configured to pull the tissue surface tocontact the abrading elements when the apparatus is placed on the tissuesurface. Such a vacuum arrangement can also stretch the tissue surfaceto provide mechanical stabilization of the tissue during abrasion. Otherexemplary techniques for mechanically stabilizing the tissue surfaceregion may also be used with exemplary embodiments of the presentinvention.

It shall further be noted that the exemplary cosmetic method describedherein is a safe and routine procedure, comparable to conventionaldermabrasion procedures that can be practiced in beauty parlors or othersettings. Further, the exemplary method described herein is likely evenless invasive than conventional dermabrasion procedures, because asignificant fraction of the epidermis remains undamaged, which can leadto reduced swelling, reduced risk of infection, and faster healingtimes. Moreover, the exemplary method can minimally invasive, does notpresent a substantial health risk, and does not require professionalmedical expertise to be performed. For example, no clinician is neededto perform the exemplary embodiments of the method described herein, andno risk, much less a health risk, is presented for a person beingtreated with said cosmetic method, as will become clear from thefollowing description.

In a still further exemplary embodiment, the exemplary apparatus caninclude a reciprocating arrangement affixed to the one or more shaftsand attached abrading elements. The reciprocating arrangement caninclude a motor or other actuator configured to repeatedly advance andwithdraw the abrading elements onto the skin surface. The reciprocatingarrangement can be provided in a housing that facilitates manipulationof the apparatus, e.g., placement of the apparatus on the tissue beingtreated and/or traversing the apparatus over the tissue. The housing canoptionally be configured to stretch or otherwise stabilize the skintissue proximal to the shafts and abrading elements, e.g., to reducedeformation of the tissue and/or improve accuracy of the placement ofthe abrading elements on the tissue. The reciprocating arrangement caninclude an actuator and controller. In further embodiments, thereciprocating arrangement can include a trigger mechanism and a springarrangement or the like, which may be configured to contact the abradingelements onto the skin surface, e.g., with a particular or predeterminedforce or depth, and alternately withdraw them from the skin surface. Thereciprocating arrangement can further include a translational controllerconfigured to translate the shaft(s) and abrading element(s) over thetissue in at least one direction, and optionally in two orthogonaldirections, to provide larger regions of treatment without translatingthe entire apparatus over the tissue surface.

These and other objects, features and advantages of the presentdisclosure will become apparent upon reading the following detaileddescription of exemplary embodiments of the present disclosure, whentaken in conjunction with the appended drawings and claims.

BRIEF DESCRIPTION OF THE DRAWINGS

Further objects, features and advantages of the present disclosure willbecome apparent from the following detailed description taken inconjunction with the accompanying figures showing illustrativeembodiments, results and/or features of the exemplary embodiments of thepresent invention, in which:

FIG. 1 is a schematic side view of an exemplary apparatus formechanically generating fractional damage in tissue in accordance withexemplary embodiments of the disclosure;

FIG. 2 is a frontal view of the exemplary apparatus shown in FIG. 1;

FIG. 3 is a schematic side view of a second exemplary apparatus formechanically generating discontinuous dermabrasion in tissue inaccordance with further exemplary embodiments of the disclosure; and

FIG. 4 is a schematic side view of a third exemplary apparatus formechanically generating discontinuous dermabrasion in tissue inaccordance with still further exemplary embodiments of the disclosure.

Throughout the drawings, the same reference numerals and characters,unless otherwise stated, are used to denote like features, elements,components, or portions of the illustrated embodiments. Moreover, whilethe present disclosure will now be described in detail with reference tothe figures, it is done so in connection with the illustrativeembodiments and is not limited by the particular exemplary embodimentsillustrated in the figures. It is intended that changes andmodifications can be made to the described embodiments without departingfrom the true scope and spirit of the present disclosure as defined bythe appended claims.

DETAILED DESCRIPTION OF EXEMPLARY EMBODIMENTS

According to exemplary embodiments of the present disclosure, method andapparatus can be provided for generating discontinuous damage in tissuesuch as, but not limited to, skin tissue. Such damage can be produced toany desired depth based on the configuration of the exemplary apparatus.For example, small areas of tissue damage (e.g., less than about 1 mm inwidth or diameter) can be created mechanically that extend to anydesired depth within the skin, for example, down to the dermal/epidermaljunction or just below it. In further exemplary embodiments, the depthof the abraded and removed tissue can extend into the dermis.

A side cross-sectional view of an exemplary apparatus 100 for generatingdiscontinuous damage in a tissue is shown in FIG. 1. The exemplaryapparatus 100 can include a plurality of shafts 120 that can berotatably coupled to a substrate 130. For example, the shafts 120 canpass at least partially through holes provided in the substrate 130, orbe coupled to rotational bearings affixed to the substrate 130, etc. Thesubstrate 130 can be formed as part of a housing, or be affixed to ahousing. The shafts 120 can be substantially parallel to one another,and can be rotatable around and/or slidable along their longitudinalaxes relative to the substrate 130. An abrading element 110 can beaffixed to the distal end of each shaft 120. In certain embodiments, theabrading elements 110 can be formed as a shaped portion of the distalends of the shafts 120.

The abrading elements 110 can preferably be small, for example, having awidth or diameter that is less than about 1 mm, or less than about 0.8mm. In further exemplary embodiments, the width of the abrading element110 can be less than about 0.5 mm, for example, between about 0.3 mm andabout 0.5 mm. The shape of the abrading elements 110 can be spherical,cylindrical, conical, or the like. Each abrading element 110 can includean abrasive medium provided over at least a part of the outer surface.The abrasive medium can include, for example, a diamond or metallicpowder, carbide particles, or the like. In further exemplaryembodiments, the abrasive medium can be a pattern or plurality ofrecesses, grooves, protrusions, or the like formed in the abradingelements 110. Such exemplary geometric features can be etched in siliconor another material that forms the abrading element 110, for example, inthe shape of a conventional pineapple burr arrangement, etc.

The proximal end of the shafts 120 can be coupled to a drive arrangement150. The drive arrangement 150 can optionally be configured tocontrollably rotate the shafts 120, at either low or high rotationalspeeds. For example, the drive arrangement 150 can include a small fanor turbine affixed to the proximal end of each of the shafts 120. Arapid flow of air or another gas, or a plurality of bursts or pulses ofsuch gas, can be directed over the fans or turbines to drive a rapidrotation of the shafts 120 and of the abrading elements 110 affixedthereto. In certain exemplary embodiments, the rotation can be smalleach time the abrading elements 110 contact the skin, e.g., they can belimited to just a few full (360 degree) rotations, or one full rotationor less, to limit the amount of abrasion that is generated on the skinsurface. The amount of rotation can be selected, for example, based onthe structure and abrasiveness of the abrasive elements 110 used.

Alternatively, the drive arrangement 150 can include a gear affixed tothe proximal portion of each shaft 120. The drive arrangement 150 canfurther include a conventional rack-and-pinion mechanism or the like, inwhich a toothed edge of a flat rod can engage a plurality of the gearsthat are attached to shafts 120 that are aligned in a row through thesubstrate 130. The shafts 120 can then be controllably rotated byrapidly moving the flat rod back and forth, converting the translationalmotion of the rod to rotational movement of the shafts 120 affixed tothe gears. Other gear arrangements can be provided in the drivearrangement 150 to controllably rotate one or more of the shafts 120.

A bottom view of the exemplary apparatus 100 is shown in FIG. 2. Theabrading elements 110—and shafts 120 they are affixed to—can be arrangedin a square or rectangular pattern, as shown in FIG. 2. Alternatively,the rows of abrading elements 110 can be offset or staggered to form atriangular pattern or other spatial pattern. Other arrangements of theabrading elements 110 can also be used, such as a random distribution ofthe abrading elements 110 and the corresponding shafts 120 on thesubstrate 130. If the shafts 120 are not arranged in rows, it can bepreferable to use a turbine mechanism or the like for the drivearrangement 150, rather than a rack-and-pinion mechanism. The shape ofthe bottom of the substrate 130 shown in FIG. 2 is substantially square.Other shapes and sizes of the substrate 130 can also be used, anddifferent numbers of abrading elements 110 (and corresponding shafts120) can be provided.

The lower portion of the exemplary apparatus 100 can be pressed onto atissue surface, and the abrading elements 110 can be rotated at highspeeds so they abrade tissue at the skin surface and optionallypenetrate some depth into the tissue. This exemplary procedure can forma plurality of small, discrete abraded regions or holes in the tissue.The holes can have a spacing substantially similar to the spacing of theshafts 120 in the apparatus 100. In certain exemplary embodiments, theabrading elements 110 can be configured to protrude only a smalldistance from the bottom surface of the substrate 130, e.g. to limit thedepth at which tissue is abraded when the apparatus 100 is placed on thetissue to be treated. For example, the distal ends of the abradingelements 110 can protrude about 3 mm from the bottom surface of thesubstrate 130, such that the abraded depth may extend into the upperepidermal layer in skin tissue. Smaller protrusion distances may beused, e.g., less than about 2 mm, or less than about 1 mm, to reduce orlimit the depth of skin tissue that is abraded to the epidermal layer orjust below the dermal/epidermal junction.

The plurality of holes or abraded regions abrasively formed by theexemplary apparatus 100 can represent regions of damaged tissue that mayelucidate a healing response in the tissue. This behavior can bequalitatively similar to the effects produced using conventionallaser-based fractional resurfacing techniques and systems. The size ofthe holes can be determined by the size of the abrading elements 110 andthe depth to which they are introduced into the tissue. The hole sizescan be slightly larger than the diameter of the abrading elements 110based on local mechanical disruption of the tissue. In conventionalfractional resurfacing techniques, the diameter or width of the damagedtissue regions may be less than about 1 mm, or less than about 0.5 mm,and can also generate thermal damage zones around these damaged regions.The exemplary apparatus 100 can be configured to form holes or abradedregions having similar dimensions, with little or no adjacent thermaldamage zone because the damage is generated mechanically. Larger orsmaller holes can be formed in certain tissues to achieve particularhealing responses or other physical or biological responses. These holescan be formed discretely such that each hole is substantially surroundedby healthy, undamaged tissue. The presence of healthy tissue proximal tothe holes or abraded regions can facilitate a more rapid healing of theskin while producing cosmetically desirable effects, such as wrinklereduction and/or collagen formation.

The surface or areal fraction of tissue damage can be determined by thediameters and spacings of the abrading elements 110 provided on theshafts 120 connected to the substrate 130. For example, the fraction ofthe tissue surface covered by abraded holes can be as small as about 0.1or large as about 0.7. In general, areal fractions of the holes thusformed can be between about 0.2 and 0.5 to achieve a sufficientdesirable healing response while being well-tolerated, so that healingtimes are relatively short. Smaller areal coverages can also begenerated for certain areas of skin, e.g., skin that may be moresensitive to larger densities of damage.

The depth of the holes formed by abrasive removal of tissue cancorrespond approximately to the distance that the abrading elements 110protrude from a lower surface of the substrate 130. For example, theabrading elements 110 can extend about 1 mm below the lower surface ofthe substrate 130. This length can facilitate abrasive formation ofholes that extend to a depth that is approximately midway through thedermal layer. Shallower or deeper holes can be formed by altering oradjusting the protrusion distances of the abrading elements 110 from thebottom of the substrate 130. These exemplary distances and correspondinghole depths can be selected based on the characteristics of the tissuebeing treated and the desired effects to be achieved.

A side view of a further exemplary apparatus 300 for generating abrasivediscontinuous damage in tissue according to another exemplary embodimentis shown in FIG. 3. This exemplary apparatus 300 can be similar to theexemplary apparatus 100 shown in FIG. 1. The exemplary apparatus 300further includes a lip or rim 320 around the lower perimeter of thesubstrate 130. A vacuum conduit 330 can be provided in the substratethat includes one or more openings along the bottom of the substrate130. The apparatus 300 can be placed onto the surface of a tissue 350,such that the lower rim 320 rests on the tissue 350.

A vacuum source 340 (e.g., a source of a fluid at a pressure lower thanatmospheric or ambient pressure) can be coupled to the vacuum conduit330, such that the tissue surface 350 is pulled up towards the abradingelements 110. The fluid can be a gas, e.g. air or nitrogen or the like.Alternatively, the fluid can be a liquid such as, e.g., water or asaline solution. The vacuum source 340 can be, for example, a pump, apiston arrangement, a reservoir or enclosure provided with a valvearrangement, or the like. By controlling the vacuum source 340, thetissue 350 can be brought into contact with the abrading elements 110 toabrade a plurality of small holes in the tissue 350. In certainexemplary embodiments, the drive arrangement 150 can optionally beactivated to spin the abrading elements 110, e.g., at high rotationalspeeds. The vacuum source 340 and the vacuum conduit 330 can alsofacilitate removal of abraded tissue debris when forming the smallholes. Further, the exemplary configuration of the substrate 130, rim320 and optionally the vacuum conduit 330 can stretch the tissue 350,which can provide mechanical stabilization of the tissue 350 while it isbeing abraded.

An exemplary apparatus 400 in accordance with further exemplaryembodiments of the present invention is shown in FIG. 4. The exemplaryapparatus 400 can include one or more shafts 120 affixed or coupled to areciprocating arrangement 420, which may be provided at least partiallywithin a housing 430. The shafts 120 can be rotatable, as describedherein above, or non-rotating. An abrading element 110 can be providedat the distal end of the shafts 120. The housing 430 can also include ahandle 410 to facilitate manipulation of the exemplary apparatus 400.The reciprocating arrangement 420 can be configured to displace theshaft(s) 120 back and forth along a direction that can be substantiallyparallel to the axis of the shaft 120. For example, the reciprocatingarrangement 420 can be powered by a motor or the like, and controlled bya switch that can turn the reciprocating arrangement 420 on and off, andmay further control the reciprocating frequency and/or protrusiondistance of the abrading element 110 below the lower surface of thehousing 430.

The exemplary apparatus 400 can be traversed over a region of tissue tobe treated such that the one or more abrading elements 110 provided atthe distal ends of the shafts 120 form a plurality of discrete abradedregions or holes in the tissue 350 as described herein. The exemplarydepth of the holes or abraded regions in the tissue 350 can bedetermined by the configuration of the reciprocating arrangement 420.The exemplary spacing of such holes in the tissue 350 can be determined,e.g., by the reciprocating frequency and/or the translational speed ofthe apparatus 400 over the tissue surface. For example, the exemplaryapparatus 400 can include a speed and/or position sensing arrangementthat can be provided in communication with the reciprocating arrangement420 to generate a particular spacing and/or areal fraction of holes.

According to yet further exemplary embodiments, the housing 430 can beconfigured to stretch skin or other tissue when the exemplary apparatus400 is placed on the tissue to be treated. Such stretching canfacilitate mechanical stabilization of the tissue, e.g., to reduce oravoid deformation of the tissue 350 while the abrading elements 110 arein contact with the tissue 350. Such stretching of the tissue 350 canalso reduce the effective size of the holes or discrete abraded regionsof damage formed by the apparatus when the tissue 350 is allowed torelax after treatment. Alternatively, the surface of the tissue 350 tobe treated can be stretched or stabilized using other exemplarytechniques prior to and/or during treatment of the region in accordancewith any of the exemplary embodiments described herein.

In still a further exemplary embodiment, the reciprocating arrangement420 can further include a translational mechanism configured totranslate the one or more shafts 120 over the tissue surface in one ortwo orthogonal directions. For example, the reciprocating arrangement420 can be configured to translate the one or more shafts 120 over aportion of the tissue 350 while the apparatus 400 is held stationarywith respect to the tissue surface. In one exemplary embodiment, thereciprocating arrangement 420 can be configured to translate the one ormore shafts 120 along a single direction to form one or more rows ofholes or abraded regions using the abrading elements 110 provided at thedistal ends of the shafts 120. The exemplary apparatus 400 canoptionally be translated over the tissue surface after such rows areformed, e.g., in a direction that is not parallel to the row, togenerate a plurality of such holes or abraded regions over a larger areaof the tissue.

According to yet another embodiment, the reciprocating arrangement 420can include a spring-loaded mechanism. For example, a trigger mechanismand spring arrangement or other tensile mechanism can be coupled to theone or more shafts 120 within the housing 430. Activating the triggercan extend the shafts 120 such that the abrading elements 110 protrude aparticular distance from the lower portion of the housing 430. When thetrigger is released, the spring arrangement can retract the ends of theshafts 120 and associated abrading elements away from the skin surfacewhen the lower portion of the housing 430 is placed against the tissuesurface to be treated. The housing 430 and reciprocating arrangement 420can be configured such that the abrading elements 110 protrude apreselected distance from a lower surface of the housing 430 when thetrigger is fully engaged, e.g., to limit the depth of holes formed bythe abrading elements 110. This exemplary embodiment of thereciprocating arrangement 420 can thereby facilitate repeated contact ofthe abrading elements 110 against the skin surface with a known forceand/or at a predetermined impact depth to achieve a desirable amount ofabrading tissue damage with each contact. Other configurations of thereciprocating arrangement 420 can also be used in embodiments of thepresent invention to achieve similar effects.

In still further exemplary embodiments of the present disclosure, any ofthe exemplary apparatuses described herein can be configured to generatea plurality of holes or abraded regions in any of a variety of spatialdistributions in the tissue being treated. For example, the holes ordiscrete abraded regions can be formed as one or more rows, a regulartwo-dimensional pattern, a random distribution, or the like. Suchpatterns or spatial distributions of holes can be generated based on,e.g., the configuration of the one or more needles 120 provided, theproperties of the reciprocating arrangement 420, and/or the rate oftranslation of the exemplary apparatus 400 over the tissue surface.

For example, a topical anesthetic and/or cooling/freezing can be appliedto the tissue surface before forming the abraded holes to reduce anysensation of pain or discomfort during the procedure. Further, partiallyfreezing the tissue can reduce the amount of tissue tearing and formsmoother holes. Antibiotics or other therapeutic substances can also beapplied topically after the holes have been formed to promote healing,skin tightening, and/or other desirable effects.

The foregoing merely illustrates the principles of the presentinvention.

Other variations to the disclosed embodiments can be understood andeffected by those skilled in the art in practising the claimed inventionfrom a study of the drawings, the disclosure, and the appended claims.In the claims, the word “comprising” does not exclude other elements orsteps and the indefinite article “a” or “an” does not exclude aplurality. The mere fact that certain measures are recited in mutuallydifferent dependent claims does not indicate that a combination of thesemeasures cannot be used advantageously. Any reference signs in theclaims should not be construed as limiting the scope of the claims.Various modifications and alterations to the described embodiments willbe apparent to those skilled in the art in view of the teachings herein.It will thus be appreciated that those skilled in the art will be ableto devise numerous techniques which, although not explicitly describedherein, embody the principles of the present invention and are thuswithin the spirit and scope of the present invention. All referencescited herein are incorporated herein by reference in their entireties.

1. An apparatus for cosmetic resurfacing of a skin tissue, comprising:at least one shaft; and an abrading element coupled to a distal end ofthe shaft, wherein a width of the abrading element is less than about 1mm, and wherein the abrading element is configured to contact a surfaceof the skin tissue to remove at least one portion of the skin tissue. 2.The apparatus of claim 1, wherein the width of the abrading element isless than about 0.8 mm.
 3. The apparatus of claim 1, wherein the widthof the abrading element is less than about 0.5 mm.
 4. The apparatus ofclaim 1, wherein the width of the abrading element is between about 0.3mm and about 0.5 mm.
 5. The apparatus of claim 1, wherein the at leastone shaft comprises a plurality of shafts.
 6. The apparatus of any ofclaims 1, further comprising a substrate, wherein the at least one shaftis rotatably coupled to the substrate.
 7. The apparatus of any of claims1, further compnsmg a drive arrangement configured to rotate each of theshafts around a longitudinal axis thereof.
 8. The apparatus of claim 7,wherein the drive arrangement is further configured to translate each ofthe shafts in a direction substantially along the longitudinal axisthereof.
 9. The apparatus of any of claims 1, further comprising areciprocating arrangement configured to repeatedly translate the atleast one abrading element in a forward translational direction and abackward translation direction substantially along a longitudinal axisof the at least one shaft.
 10. The apparatus of claim 9, wherein thereciprocating arrangement comprises an actuator and a controlarrangement.
 11. The apparatus of claim 9, wherein the reciprocatingarrangement comprises a trigger mechanism and a spring arrangement. 12.The apparatus of any of claims 9, wherein the reciprocating arrangementis configured to bring the at least one abrading element in contact withthe surface of the skin tissue at least one of to a particular depth, orusing a particular force.
 13. The apparatus of any of claims 6, furthercomprising a conduit coupled to the substrate, wherein the conduit isconfigured to facilitate contact between the surface of the skin tissueand the at least one abrading element when the conduit is placed incommunication with a low-pressure source.
 14. A method for resurfacingskin tissue, comprising: producing a plurality of holes in the skintissue usmg a rotating arrangement, wherein each hole is produced byremoving a portion of the skin tissue, and wherein a width of each holeis less than about 1 mm.
 15. The method of claim 14, wherein a width ofeach hole is less than about 0.8 mm.
 16. The method of claim 14, whereina width of each hole is less than about 0.5 mm.
 17. The method of claim14, wherein a width of each hole is between about 0.3 mm and about 0.5mm.
 18. The method of any of claims 14, wherein a surface area fractionof the removed tissue is between about 0.1 and 0.7.
 19. The method ofany of claims 14, wherein a surface area fraction of the removed tissueis between about 0.2 and 0.5.
 20. The method of any of claims 14,wherein the rotating arrangement comprises at least one shaft and anabrading element provided at a distal end of the shaft.
 21. The methodof any of claims 14, wherein the rotating arrangement comprises aplurality of shafts and an abrading element provided at a distal end ofeach of the shafts.
 22. The method of any of claims 20, wherein therotating arrangement further comprises a reciprocating arrangementadapted or structured to repeatedly translate the at least one shaft ina forward translational direction and a backward translation directionsubstantially along a longitudinal axis thereof.
 23. The method of anyof claims 14, wherein at least one of the holes extends to at least adepth of a dermal/epidermal junction.